Care and Support for Your Patients
Make A Referral
When you refer your patient to Covenant Care, you, your patient and their family have our ongoing support with whatever is needed.
Call us at 1-855-CARE-365 or fill-out the contact form to get started.
Determining Eligibility
For Home Health Care, Companion & Personal Care, Hospice and Palliative Care referrals, physicians should weigh their experienced evaluation with input from the patient and family. Our Covenant Care team is available for assistance with patient assessments and family consultations to identify eligibility.
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We know these conversations can be difficult, we can help. Call us today.
Provider FAQs
To elect hospice under Medicare, an individual must be entitled to Medicare Part A and certified as being terminally ill by a physician with an expected prognosis of six months or less. Medicare Part A covers hospice services, even for patients with a Medicare Advantage (Part C) plan.
By law, healthcare professionals must certify that patients meet guidelines to be eligible for a referral to a hospice provider. There are several guidelines available for various conditions related to Alzheimer's, cancer, cardiac and other conditions. Contact COvenant Care for assistance in the evaluation of your patient.
Covenant Care provides specialty nurses and doctors, trained in palliative care and symptom control. Home health aides, chaplains, social workers, grief and bereavement specialists, and volunteers are on the team that supports you in the care of your patient.
Covenant is all about respecting wishes. We respect the wishes of the patient and we admire and respect our patients’ attending physicians.
No, if you want to continue as the attending physician, Covenant Care supports that doctor-patient relationship. If you choose to refer your patient to the Covenant physician, we will continue to keep you informed of your patient’s status.
Call us at 1.855.CARE.365
Request a Covenant Care evaluation. Our specialists can help you determine the prognosis and care needs of your patient.
Yes. Covenant will provide your office staff the information and codes so that you can bill and be paid for your professional services.
At the time when a Medicare beneficiary elects hospice care, he/she may designate an attending physician. (The attending physician is defined by Medicare as the physician or nurse practitioner which is identified by the individual at the time he/she elects hospice coverage as having the most significant role in the determination and delivery of his/her medical care.)
If the attending physician is NOT employed by Covenant Care, the attending physician or nurse practitioner can bill directly to Medicare Part B for their services for reimbursement.
When billing Medicare Part B as the “attending physician” (which may include a Nurse Practitioner), the HCPCS modifier GV must be submitted for the services provided to patients enrolled in Covenant Hospice. Services submitted without one of these modifier will be denied.
The GV modifier indicates the attending physician is NOT employed or paid under an agreement by the patient’s hospice provider.
Services by a nurse practitioner are only billable if the nurse practitioner has been elected, by the patient, as the attending physician.
Professional services related to the terminal illness provided by any physician other than the “attending physician” are considered to be “consulting physician” services. The consulting physician must look to Covenant Hospice for payment of these services. Covenant Hospice will bill Medicare Part A and reimburse the physician based upon a contractual agreement.
The consulting physician must have a signed letter of agreement with Covenant Hospice. One agreement for a group of physicians is permitted as long as all of the physicians in that group are listed on the agreement.
Covenant Hospice is responsible for reimbursing the physician for the services as indicated in the letter of agreement. Covenant Hospice currently reimburses 100% of the Medicare fee schedule. No co pays are collected from the patient.
The services must be related to the terminal illness and within the hospice plan of care. Initially, claims should be submitted to Covenant Hospice for review to determine payment.
If the service is determined by Covenant Hospice to be unrelated to the terminal illness the physician should bill Medicare directly using the GW modifier. The GW modifier indicates the service was not related to the patient’s terminal illness. Services submitted without this modifier will be denied.
If the service is determined by Covenant Hospice to be outside the plan of care, the physician should bill Medicare directly.
Physicians Assistants and Nurse Practitioners are not allowed to bill Covenant Hospice as a consulting physician as the hospice is unable to receive reimbursement from Medicare Part A. They should bill Medicare and other insurance companies directly.
The physician should bill private insurance companies directly.
For additional questions or help, you may contact our Physician Reimbursement Specialist at 850.202.0929.
Our physicians are happy to answer further questions you may have about our services. Contact us at 1.855.CARE.365.
